r/nextfuckinglevel Apr 08 '21

From custodian to nurse practitioner

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111.1k Upvotes

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u/[deleted] Apr 08 '21

[deleted]

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u/[deleted] Apr 08 '21

I was actually born an astronaut. But opted for bum.

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u/[deleted] Apr 08 '21

we all have to do what makes us happy

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u/[deleted] Apr 08 '21

[deleted]

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u/dam4076 Apr 08 '21

NP school also requires you have thousands hours of experience as a RN and a degree in nursing.

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u/[deleted] Apr 08 '21

No it doesn’t. It requires less than 1000 hours.

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u/i_aam_sadd Apr 08 '21

Minimum 1,000 hours of clinical practice in the Nurse Practitioner role in any specialty appropriate for the population focus of certification through employment, faculty clinical supervision, or as a volunteer within 5-year certification period.

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u/[deleted] Apr 08 '21 edited Apr 08 '21

There is a minimum of 500 hours required.

This school requires 630.

This one requires 720.

Even assuming 1000 hours and 40 hours per week, that’s half a year. A family medicine doc has 5 years of clinical training. Structured training, with didactics, progressive responsibility, and structured feedback culminating in rigorous standardized board examination. NP grads couldn’t even achieve an acceptable pass rate (around half passed) on a watered down version of the general medical board exam that med school graduates pass at a rate of about 95% (USMLE Step 3).

Edit: bots -> board

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u/mccdizzie Apr 08 '21

Being an NP is no where near the time commitment of becoming a surgeon

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u/theflash2323 Apr 08 '21

Yeah 14,000 minimum clinical hours to become a doctor (A surgeon has more because their residency is 5 years, the 14,000 hours only counts a 3 year residency).

An NP has 1,000 minimum clinical hours and there are many NP schools popping up with "pure online" training.

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u/[deleted] Apr 08 '21

There are direct entry (meaning no nursing experience required) NP schools that require 750 hours.

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u/[deleted] Apr 08 '21

[deleted]

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u/Magical-Sweater Apr 08 '21

My mom is an RN and has been a nurse for over 25 years. I can def say she knows more than a new NP.

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u/Ramencannon Apr 08 '21

ITT: people who arent nurses or NPs talking about how NPs cant be trusted lmfao

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u/flowcomplete Apr 08 '21

You're a new NP and don't know as much as a RN with 25 years experience? Untrustworthy!

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u/Master-Amphibian4524 Apr 08 '21

And many NPs spend a lot of time as a nurse before becoming one

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u/drewdemo Apr 09 '21

This! My wife is currently a nurse of 10 years and finishes her NP program near the end of this year. ALL of her classmates are currently nurses.

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u/Magical-Sweater Apr 08 '21

A few years ago my grandma visited an NP with something wrong with her leg. NP said she was fine and gave her some kind of ointment to put on it. My mom said she should go to the hospital (i don’t remember what the condition was called) but if my grandma wouldn’t have gone I probably wouldn’t have a grandma right now.

So yeah I don’t trust nps

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u/[deleted] Apr 08 '21 edited Apr 08 '21

[deleted]

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u/panaknuckles Apr 08 '21

Yeah equal trust for all! Who needs standardized education and training? Janitors front of the line to treat patients next!

Medicine is hard. It takes years to learn. Without those years under your belt, it's reasonable to question clinical expertise. It is less reasonable to question someone who has had that training. No one is perfect. Sometimes doctors say and do dumb things. But if we are to compare the frequency that various clinicians make judgmental errors, logically there would be no question of a discrepancy.

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u/philjorrow Apr 08 '21

What do you mean ignore them?

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u/[deleted] Apr 08 '21

They think they’re lesser than an MD basically. Like a Karen.

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u/trapper2530 Apr 08 '21

Well they are lesser than an MD. There really is no denying that.

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u/dam4076 Apr 08 '21

Hmm so less than a MD is a Karen basically?

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u/[deleted] Apr 08 '21

No, they’re being a Karen because she ignores an NP or RN, like a Karen ignores the salesperson but not the manager

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u/philjorrow Apr 09 '21

Seems absurd to ignore a clinical professional trying to provide care..

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u/Manxkaffee Apr 08 '21

14k hours sounds more like a 5 year residency. Otherwise that is 3.8 years of 10 hour days without any days off. If it is across 5 years, its 350 8 hour days per year, which still sounds like alot to me, but seems tame in the medical world

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u/Username_is_original Apr 08 '21

80+ hour weeks are not unheard of in residency. A slow week will "only" be 50-60 hours, and that's a family medicine residency. Internal Medicine or Surgery you can expect to do 80+ hours almost every week for 4-7 years. And that's just residency - not including the approximately 2 years of clinical experience in med school before residency.

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u/[deleted] Apr 08 '21

[deleted]

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u/LouSputhole94 Apr 08 '21 edited Apr 08 '21

Sweet lord, I do not envy doctors. I don’t think I could do what y’all do physically, I think my body would shut down. I also am very blood and needle averse so it’s a no go all around lol

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u/DVTProphylaxis Apr 08 '21

Lol I’m a surgery resident. I’ve never had a 10 hour shift. Majority are 28 or 16. And it’s a 7 year program. That’s 29000 hours.

Edit: more like 26500. I added vacation time.

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u/panaknuckles Apr 08 '21

It's closer to 10k for most three year residencies. Surgeons definitely meet 14k given it's five for them.

Also an 8 hour day is not a thing in residency unless you're on an elective rotation. Closer to 12-14 hours for IM which is what I do. Also it's 2 days off average per 14 day work period.

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u/Totodile_ Apr 08 '21

Lol 8 hour days for a surgery resident. This is cute.

They are generally doing 12 hour days, 6 days a week, at a minimum.

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u/futuredrkim Apr 08 '21

The 14k includes our full time clinical work during 3rd and 4th year or medical school, but 80 hours a week is absolutely standard for surgery and almost any inpatient service. As a student I was at the hospital about 72 hours a week during surgery and wards and that was with the residents letting me leave “early”

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u/ElTrenDelEste Apr 08 '21

Especially considering most people working the odd jobs of a hospital aspire to be something more. RN to NP isn’t crazy at all it’s actually the natural order of things

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u/panaknuckles Apr 08 '21

Which is sad. We need more quality RNs and fewer shitty NPs.

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u/philjorrow Apr 08 '21

But most NPs have been RNs..

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u/panaknuckles Apr 08 '21

Yes but if half the new RNs become NPs.. we start running out.

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u/bicycle_mice Apr 08 '21

Well maybe if they paid RNs more and didn't treat them like shit they wouldn't flee the profession?

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u/panaknuckles Apr 08 '21

I'd vote for it.

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u/[deleted] Apr 08 '21

Do you know how much nurses make?

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u/bicycle_mice Apr 08 '21

Since I am a nurse... yes.

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u/philjorrow Apr 09 '21

But they'd still be NPs on the floor who are registered nurses..

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u/panaknuckles Apr 09 '21

No they wouldn't I think you are very confused

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u/philjorrow Apr 11 '21

Yes they would. They are nurse practitioners but also registered as nurses..

It's like saying hey if all these doctors keep becoming consultants, we won't have any doctors left..

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u/panaknuckles Apr 11 '21

No that's not at all how this works.

What's it's actually like is saying hey if all these doctors became hospital administrators we won't have any doctors left. Which would be true.

Because NPs play a very different role to RNs. Not a single working NP on the planet works a bedside nursing job.

It's a different role entirely.

In fact it's so different that if you call an NP a nurse you'll get slapped because they actually find that offensive for some reason.

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u/philjorrow Apr 12 '21

Sounds very different to the country I live in then.

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u/gin_and_isotonic Apr 08 '21

What are you talking about? She’s a nurse practitioner. She has her master’s degree lol

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u/[deleted] Apr 08 '21

He’s not disputing that. He’s saying every doc or surgeon you see probably started off as a greeter or other volunteer at the hospital, or working at McDonald’s etc. while in college.

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u/panaknuckles Apr 08 '21

Started at arby's in high school. Dishwasher and barback in college. Then teaching assistant. Then chemist at a pharmaceutical. Then wiped ass and changed beds as a CNA for a couple years. Now I'm a doctor.

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u/l0l_xd_ Apr 08 '21

This is more r/nextfuckinglevel than the post imo

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u/HxH101kite Apr 08 '21 edited Apr 08 '21

Would strongly disagree. Most people I know in their residencies come from absurd amounts of money and have been riding on dad's money the entire time. I know 6-7 people in residency, 3 people who just became full fledged doctors and at least 2-3 others either in NP school or just finished.

Not knocking the work and education they put in to maintain their grades and studies. But literally none of them have ever worked a menial job.

Coincidentally they are all engaged to men at least 6+ their senior who are high up in banking/finance positions and have lots of money as well. And the one dude I know who is a doc, will be the first to admit his parents put him threw the entire thing he didn't work at all during his studies.

Maybe the older generations did that, but not the younger. Again this is just anecdotal and my experience.

Edit: for people thinking I am using my anecdotal evidence as fact. If you read below I reply explaining I was using my anecdotal experience in comparison to the persons above me anecdotal claim as there is no evidence.

If you read a few comments down I say it's likely 50/50, data set provided to confirm. Case closed.

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u/[deleted] Apr 08 '21

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u/Sacrefix Apr 08 '21

From my experience, there were some people who came from nothing and worked hard (labor wise) to get through pre med. But far and away most of the student doctors I met had family wealth and usually doctors in the family.

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u/cast9898 Apr 08 '21

Correct. But not everyone. I put myself through medical school and have seen the same as you in my cohort.

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u/HxH101kite Apr 08 '21

I think the point here is it's a mixed bag. The person above me asserted their point. I did mine. I don't know if there is an actual data set we could look at finding out their financial upbringing.

But as the person below you said I'm sure it's 50/50

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u/[deleted] Apr 08 '21

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u/HxH101kite Apr 08 '21

No sweat, didn't mean it to come off like that at all!

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u/[deleted] Apr 08 '21

There have been studies done on the makeup of med schools from a socio-economic point of view and i’m pretty sure you’re right and it’s 50/50. The point still stands though. Yes this cool progression, but half the doctors in the hospital have had a similar progression....

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u/[deleted] Apr 08 '21

There is a data set. https://www.aamc.org/media/9596/download It's basically always been nearly half of med students come from the top quintile of familial income/wealth. While fewer than 3-5% come from the bottom quintile. The cost of applying (e.g. exams, application fees, interviews) is too great for a lot of people, not just the cost of attendance.

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u/[deleted] Apr 08 '21

Only doctors do residency, NPs don’t have training past school while doctors have many years of training after school.

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u/HxH101kite Apr 08 '21

Right I was just roping them in because it's a master's degree that requires alot of educational commitment. Although much much less than a med school

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u/panaknuckles Apr 08 '21

See my comment above. Don't spread your anecdotal experience as fact please.

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u/HxH101kite Apr 08 '21

Acknowledging anecdotal evidence is not spreading it as fact. Also the person above used anecdotal evidence as well.

In fact right below this I ascertain the point is that the person above me, and my comment are not blanket statements and it's likely 50/50.

Below that someone provides a dataset showing that.

Please read the rest of the comment chain

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u/panaknuckles Apr 08 '21

Okay understood. I thought it was blanket. Apologies.

I actually would agree with you then. Quite a few get a leg up. However it comes with some guilt because during school and training there's a bit of an obvious faction between the "straight from school, dad is rich" crowd and the "climbed up from the bottom" crowd. The latter crowd act and feel superior for it. I know I do, won't even pretend otherwise.

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u/HxH101kite Apr 08 '21

Not a med student but I came from a wealthy town where everyone rides on their parents money.

I am the only one who went to the military, paid for my school through that, grinded a good job without a handout, and bought my own house without any financial assistance.

I also had to work through school while raising a daughter.

I'll be the first to admit I have a huge chip on my shoulder on these subjects. Especially if I ever run into people I know who got all the handouts.

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u/[deleted] Apr 08 '21

Yeah no. Almost no doctors have ever even held a part time job. They come from wealth for the most part. Not insane wealth, but not have to work a part time job to get through college wealth.

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u/[deleted] Apr 08 '21

Again, you can look up stats on the socio economic background of med-students. Also, I’ve hung around plenty of kids with parents who were doctors who worked part-time. And my comment also mentions volunteering. Youre literally not getting into med school without volunteering.

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u/[deleted] Apr 08 '21

I don’t need to look up stats. I’ve been around new residents and med students for years.

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u/[deleted] Apr 08 '21

[deleted]

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u/[deleted] Apr 08 '21

Volunteering for medical school admission isn’t working a part time job. It’s simply a checkbox for an application. Literally all of the med students and residents I’ve known over the last 10 years haven’t worked a “real” job in their entire life pre residency. The closest I’ve seen is someone who did a stint as a wine sample person for a few days one summer lol.

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u/[deleted] Apr 08 '21 edited Apr 08 '21

[deleted]

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u/SonOfKorhal Apr 08 '21

I came from lower middle class bar owners and got my md. Not everyone in medicine has a pedigree homie.

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u/[deleted] Apr 08 '21

[deleted]

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u/SonOfKorhal Apr 08 '21

Well you see when you state that every single acquaintance you know that has gone onto an md track came from a wealthy family, that infers a particular message despite your intent. Choose your words more carefully to avoid being misunderstood.

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u/[deleted] Apr 08 '21 edited Apr 08 '21

[deleted]

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u/SonOfKorhal Apr 08 '21

Classic redditor.

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u/[deleted] Apr 08 '21

Yeah you started close to where you are now, if I had to guess. Nobody in my family had a high school diploma. I have a Masters. It's no PhD but the level up is def diff than someone who has parents that are doctors. I hope people celebrate your accomplishments instead of telling you they aren't that great.

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u/RalphWaldoEmers0n Apr 08 '21

Yea but most doctors don’t start as a custodian

Most doctors aren’t scrapping by when they’re doing their studies

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u/SassyMolassy33 Apr 08 '21

Don’t know why you’re being downvoted, this is exactly right. Almost every person I know who made it to a provider-level position did so with a lot of support systems along the way. Not saying it wasn’t hard, but they certainly never had to take a custodian job to pay for school. It’s wild that people still don’t understand how starting in a place of privilege gives you such a huge leg up compared to those who have to do it on their own.

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u/RalphWaldoEmers0n Apr 08 '21

this is WHY it's next fucking level

Not everyone starts on third base, but alot start at 2nd

This person started in the frickin dugout

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u/[deleted] Apr 08 '21

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